Diabetes complications and comorbidities

Researchers have found evidence to support an increased risk for amputation among patients with type 2 diabetes taking sodium-glucose cotransporter 2 inhibitors relative to some oral treatments.

Uazman Alam and colleagues interrogate current evidence and real-world clinical scenarios to address whether enough is being done with the tools available to screen and diagnose diabetic neuropathy.

Obese patients with type 2 diabetes who undergo bariatric surgery achieve large reductions in their risk for microvascular complications, shows a real-world study.

Research shows that starting second-line sulfonylurea treatment is associated with an increased risk for cardiovascular and hypoglycemic events among patients with type 2 diabetes in clinical practice, although the risk is less if they continue using metformin rather than switching completely.

A study of patients from US administrative claims databases finds no evidence that use of canagliflozin increases the risk for below the knee amputation when compared with other sodium-glucose cotransporter 2 inhibitors or with other antidiabetic medications.

Papadopoulou E et al. J Hum Hypertens 2018. doi: 10.1038/s41371-018-0079-5

Zhu B et al. Acta Diabetol 2018. doi: 10.1007/s00592-018-1181-4

Neither the rate of administration nor the sodium chloride content of replacement fluids given to children with diabetic ketoacidosis influences their neurologic outcomes, show the results of the PECARN DKA FLUID Study.

Nishimura A et al. Diabetes Ther 2018. doi: 10.1007/s13300-018-0457-6

Dave N, Wu J, Thomas S. Curr Diab Rep 2018; 18: 44. doi: 10.1007/s11892-018-1010-8

Einarson TR et al. Cardiovasc Diabetol 2018; 17: 83. doi: 10.1186/s12933-018-0728-6

Editorial Board member Lori Berard talks through the stages and challenges associated with preparing type 2 diabetes patients for insulin therapy (9:00).

Oriot P et al. Acta Diabetol 2018. doi: 10.1007/s00592-018-1170-7

People with type 1 diabetes are approximately twice as likely to experience gastrointestinal symptoms as those without, and these symptoms are associated with poor glycemic control and quality of life, study results suggest.

Sanjay Kalra and Silver Bahendeka, East Africa Diabetes Study Group Chair, provide an overview of the latest insulin guidance developed to aid management in a challenging region, facing familiar struggles.

Deng Z et al. Diabetes Ther 2018. doi: 10.1007/s13300-018-0448-7

Modestly increasing glucagon levels when commencing physical activity could be an effective strategy for preventing exercise-induced hypoglycemia among patients with type 1 diabetes, results of a randomized crossover trial suggest.

Maskarinec G et al. Eur J Clin Nutr 2018. doi: 10.1038/s41430-018-0188-9

Ambulance call-outs for episodes of severe hypoglycemia do not consistently result in reviews of patients’ care, despite guideline recommendations, shows a study of diabetes patients in England and Wales.

The first randomized trial of islet transplantation supports its use in patients with severe, unstable type 1 diabetes.